Predictors of curative resection and long term survival of gallbladder cancer - A retrospective analysis

•Factors predicting resectability and survival of patients with gallbladder cancer and the impact of surgical obstructive jaundice (SOJ) were analyzed.•Patients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable.•Metastatic, inoperable and unresectable disease were more in the SOJ group and had lower curative resection rates (15.2% vs 51.7%; p < 0.0001).•GBC with SOJ is more likely to be unresectable.•SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival.

BackgroundGallbladder cancer (GBC) is an aggressive malignancy. We analysed factors predicting resectability and survival of patients with GBC and the impact of surgical obstructive jaundice (SOJ).MethodsFour hundred and thirty-seven patients with suspected GBC were analysed (52 excluded: benign pathology n = 35, missed GBC n = 17). The remaining 385 patients were divided into non-SOJ (n = 234) and SOJ (n = 151) groups. Predictors of resectability and long term survival were analysed and compared with their subgroups.ResultsPatients with gastric outlet obstruction, abdominal lump, weight loss and SOJ were more likely to be unresectable (p:0.04, 0.024, 0.003 and 0.003, respectively). TNM stage, node positivity and adjacent organ involvement were predictors of survival (p < 0.001, 0.008 and <0.001). Metastatic (36.7% vs 47.7%), inoperable (1.7% vs 12.6%) and unresectable disease (9.8% vs 24.5%) were more in the SOJ group and had lower curative resection rates (51.7% vs 15.2%; p < 0.0001). The 1,2 and 5-year survival rates were higher in patients in the non-SOJ than SOJ group (79.6%, 65% and 52.9% vs 48.6, 32.4% and 0%; p < 0.001).ConclusionGBC with SOJ is more likely to be unresectable. SOJ, nodal involvement, adjacent organ infiltration and higher TNM stage predict poor survival.